Why is Everyone Going Blind? The UGLY TRUTH behind the myopia epidemic

I can't see everything is blurry I've had children tell me this on a nearly daily basis in the office and it's difficult to hear every time usually the kids are 8 to 10 years old and the parents bring them in because they're having trouble seeing at school or at home I do their eye exam and I see that they're beginning to develop myopia or nearsightedness it's not too bad at first maybe a prescription of minus one or- 1 and A2 but then I see them 6 months or a year later and it goes up maybe an additional 0.5 or 1 increase in their prescription but then fast forward five 10 years down the line and sure enough these kids have gone from a minus1 when they were 8 years old all the way to a minus5 -7 - 10 or even - 12 prescription by the time they're in college and at that point they can barely even make out their own hand in front of their face unless they wear thick glasses or contact lenses and the unfortunate part is beyond the inconvenience of glasses and contact lenses having high myopia skyrockets the risk of developing blinding eye complications a recent study showed that patients with high myopia have a 845 times increase in the odds of devel veloping macular degeneration a 12.62 times increase in the odds of developing a retinal detachment a 4.55 times increased risk of posterior subcapsule cataracts and a 2.92 times increase in the risk of glaucoma and I got to say my experience as an opthalmologist backs up the findings from these studies I'm noticing an alarming increase in the number of patients maybe in their 30s or 40s with high myopia coming in with retinal tears and detachments and unfortunately these people need emergency surgery just to try to salvage their sight but depending on the severity of the problem these patients who otherwise have no other medical conditions besides being nearsighted are going permanently blind in their 30s or 40s and losing your vision that young has a serious effect on your quality of life in a recent study researchers from John's Hopkins Hospital pulled 2,000 Americans what was the worst possible ailment that could happen to them the researchers found that people feared blindness the most when the researchers pulled all the responses together they created a ranking of all the worst health conditions that someone could suffer from they found that blindness was Head and Shoulders above other conditions as the worst thing someone could get worse than Alzheimer's disease cancer AIDS loss of an arm or leg heart disease arthritis and deafness okay let's take a step back and explain what myopia or nearsightedness is normally light is focused by the cornea and lens onto the retina which is the light sensitive tissue in the back of our eyes in myopia the eye is a little bit too long and distant objects appear out of focus and blurred we can use glasses or contact lenses to help correct this blurry vision but having myopia doesn't just mean Coke bottle type glasses or contact lenses it has far greater effects on our Eye Health we all have a set amount of retina tissue you can think of our retina like a clear film that lines the back of our eyes as myopia worsens the eye gets longer and longer which causes that retina tissue to stretch and thin out and as that retina tissue is more stretched out we have a higher risk of developing retinal tears retinal detachments and retinal bleeding and that's something I see with increasing regularity young high myopes in their 20s or 30s coming in with a new retinal tear or Detachment one thing I hear a lot from parents is oh it's okay if jimothy has some near sight in his he can always just get lasic when he's older but that doesn't really fix the issue even with all the vision correction surgery like lasic or implantable lenses sure we can decrease your glasses prescription by reshaping your cornea or inserting a lens into your eye but we are not changing the overall length of the eye or the thickness of the retina so the risks of severe myopia are still there even if you've had these surgeries okay we get it myopia is bad but how big of a problem is it in the US myopia rates have risen sharply in the last few decades for example recent studies reported that 41.6% of Americans had myopia and that the rate of myopia had almost doubled over the last 30 years by 2050 it's estimated that half of the world's population will have myopia in East Asian countries like South Korea Taiwan China and Japan Studies have found that 90 to 95% of their populations have myopia today it's not at all an exaggeration to say that nearly everyone in places like South Korea and China has myopia and it's quite a big change since about 60 years ago prevalence rates of myopia and China were in the range of 10 to 20% this is not some future Pro C this epidemic is happening now on a very large scale and the unfortunate reality is that as we see these Trends continue and myopia rates increase we will see Millions more and more people going blind much younger than previously expected so what we're witnessing now in real time is this slow-moving train crash unfolding before our very eyes and the outcome on the other side will be lots of people with poor vision so what's going on why are we seeing an explosion in the rates of near sidess over the last few years historically researchers and scientists have blamed genetics and that's defin true to an extent for example one study looked at how having one or two parents with myopia affected a child's risk of developing it they found that in people who had two parents who didn't have myopia their risk of getting myopia was 7.6% if they had one parent with myopia the risk was 14.9% and if both parents had myopia the risk was 43.6% but genetics can't be the whole explanation take for example the eskimos or the Inuits in the 1940s an optometrist visited the eskimos in the Arctic and performed eye exams on them he found a 1.6% prevalence of myopia a very low rate by the 1970s repeat studies on Inuit communities revealed a 65% prevalence of myopia and in 21 to 25 year olds the prevalence was reported to be 87.8% so over 30 years the rates of myopia in the Inuit communities absolutely boomed what happened we can't just blame genetics our DNA our genome has been selectively shaped slowly over Millennia thousands and thousands of years so for a genetic change to spread through a population it would require a very long time it's very unlikely that suddenly the genetic makeup of the Eskimo population changed over the course of 20 to 30 years but what did change very quickly for these communities was their lifestyle and their environment you see for thousands of years before the eskimos or IND communities ever encountered European or Western cultures they lived mostly an outdoor Hunter and gatherer lifestyle they would hunt fish ride sled dogs outside that was a lifestyle but in the late 1800s and early 1900s European and Canadian leaders started to impose their culture on the innuit people they established churches schools and hospitals whereas previously innuit parents would teach their children by telling stories outside sharing meals and learning to hunt but after their forced assimilation into Western Civilization innuit kids were forced into boarding schools and spent much more time indoors reading books now just based on this case study alone can you definitively conclude that more indoor time and more time doing near work like reading books and studying is that the cause for the huge increase in myopia no you can't it's possible that the Inuit people changed their diet significantly in the early to mid 1900s or it's also possible that screening from myopia became more accurate as technology improved but it was this interesting finding of seeing how myopia rates exploded in the Eskimo population in the mid 1900s that led researchers to think H I wonder if there's something there an environment and lifestyle that's really moving the needle for myopia development and now more and more data is confirming that near work and time indoors is in fact playing a causal role in increased myopia at this point dozens of high quality quality clinical studies have investigated and shown the protective effect of more time outdoors in bright sunlight on the risk of developing myopia for example studies from Taiwan found that increasing outdoor time to about 80 minutes per day for school AG children reduce myopia incidents by 50% over one year another study this one from China published in the journal Opthalmology in 2022 this study built on previous studies and added that there's a dose dependent effect on bright sunlight exposure and protection against myopia that is they found that the more time kids spent Outdoors each day the lower the risk of developing myopia so scientifically what's the mechanism here why is it that sunlight and time outside seems to be protecting kids from developing myopia one of the prevailing theories is that bright sunlight stimulates the release of dopamine in the retina dopamine is a hormone that has been theorized to play a role in regulating the growth of our eye and preventing myopia for example this study from 2020 showed that increasing the dopamine activity in mice prevented them from developing myopia in another study researchers found that if they injected dopamine into the eyes of chickens they were able to prevent prent the development of myopia so by spending more time outside in the bright light we're naturally stimulating the release of dopamine into our retinas and providing protection against myopia the other benefit of being outside is that we focus much less on near objects when we're outside we can look out into the distance at the sky clouds mountains or trees far away conversely when we're inside we're more likely to focus on near objects things like books the computer or cell phones new work has also been theorized as a contributing factor to the increase in myopia this study for example is a review which looked at the previous published research studies on nearwork and myopia after putting all the results together they found that more time spent on nearwork activities was associated with the higher odds of developing myopia they also found a dose dependent relationship and found that the odds of myopia increased by 2% for each additional hour of nearwork per week the researchers also went on to report that individuals who perform more near work activities had a 80% higher risk of developing myopia so we're seeing more research show us that more time outside in the bright sunlight and looking at far objects is a great way to try to prevent myopia but as we all know today's modern lifestyle centered around smartphones computers and screens makes this more difficult than in the past countries such as Taiwan have taken note of these studies and have used them to design Community interventions to try to curve the increase of myopia for example in 2010 Taiwan implemented what was called the T 120 program which translates to Everyday 120 the 120 stands for 120 Minutes or 2 hours per day spent outside this is because previous Studies have shown that 14 hours of outdoor time per week or B basically 2 hours per day was shown to decrease the rates of myopia in school- a children so in 2010 Taiwanese public health and school officials implemented the program it encouraged kids to spend 2 hours outside in the sunlight every day and you can see the immediate impact of the program from 2001 to 2010 you can see the rates of myopia continuing to increase but after the program was implemented they were able not only to Halt the increase of myopia but actually to reverse the trend and to make the rates of myopia decrease things were going well until unfortunately the co pandemic hit forcing a whole whole generation of children to shelter indoors for several months or even years several studies are now showing the impact of Co 19 indoor isolation and its effects on myopia scientists have reported that after lockdowns and home confinement for billions of people around the world rates of myopia have increased in children from China to India Spain Italy and turkey and so what we are seeing is that modern lifestyle and culture is making it more and more difficult for our children to stay outside whether it's an increase in the focus on education more studying more reading or the widespread adoption of smart phones and tablets or maybe it's rising temperatures a global pandemic air pollution worries about violent crime whatever the cause may be our kids are staying indoors for longer periods of time than ever before if spending more time Outdoors is really difficult for our children what other treatment options do we have to prevent myopia well we have atropine which is a muscle relaxing eye drop atropine paralyzes the CI muscle which is the muscle that controls the size of our pupils and several research Studies have shown that nightly use of atropine eye drops in children helps to prevent the progression of myopia we also have ortho kology or Ortho contact lenses which have a special shape and are worn overnight while you're sleeping these contacts temporarily change the shape of the cornea so that peripheral vision is focused in front of the retina rather than behind it this removes the stimulus for further growth of the eye and helps to prevent the progression of myopia Beyond outdoor time atropine and Ortho caraty lenses Vision scientists around the world are also continuing to investigate other methods to try to decrease the rates of myopia for example in China researchers are experimenting with glass walled classrooms to allow more sunlight to get into children's eyes during the day and in 2022 researchers published a study showing that shining a red light into children's eyes twice a day helped to prevent the progression of myopia so we will continue to see more and more treatment options to help prevent the myopia epidemic in coming years but in the meantime research consistently shows that more time outside for our kids is one of the most effective ways to help protect their vision from myopia not only is more outdoor time good for our children's eyes but it'll probably give them more physical activity as well decreasing the risk of obesity and elevating moon and the best part it's free I'm Dr Michael CH with P Hills iare see you next time

Channel: Michael Chua, MD

Views: 1,095,874

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Id: lmIsJXw3lP0

Length: 12min 4sec (724 seconds)

Published: Fri Nov 10 2023